{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:28Z","timestamp":1790726428631,"version":"4.1.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2024,8,28]],"date-time":"2024-08-28T00:00:00Z","timestamp":1724803200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Acute blood loss and uncontrolled hemorrhage in trauma require quick identification and action to restore circulating volume and save the patient. These patients have the opportunity to receive massive transfusion (MT) to reduce mortality rates and avoid overtransfusion using a suitable ratio of blood components. This study aims to systematically review and analyze the predictive factors for the activation of MT protocol (MTP) in trauma patients, which is critical for improving clinical decision-making and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>PubMed, ScienceDirect, Cochrane, and other sources were searched for articles from 2007 to 2020. Conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, this systematic review included original studies published in English, involving trauma patients aged 15 years or older who received MTP. The risk of bias (RoB) was assessed using the RoB in Nonrandomized Studies of Interventions-I and RoB 2 tools, and statistical analysis was performed, focusing on the homogeneity of effect sizes across trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The articles search identified a total of 424 studies. Nine studies met all inclusion criteria. The most common predictors were age, sex, systolic blood pressure (SBP), heart rate (HR), hemoglobin (Hb) levels, international normalized ratio (INR), base excess (BE), and lactate levels. The analysis showed that parameters such as SBP, HR, Hb, INR, BE, and lactate were significantly associated with the activation of MTP. However, age and sex were not significant predictors. The survival rate was notably lower in the MTP group compared to the non-MTP group. There was no evidence of publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Several physiological parameters: low SBP, elevated HR, reduced Hb, increased INR, diminished BE, and elevated lactate are significantly correlated with an increased likelihood of necessitating MTP in trauma patients. Among those who received MTP, the survival rate was lower compared to the non-MTP group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jets.jets_19_24","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T07:05:56Z","timestamp":1724915156000},"page":"212-220","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Identification of Predictive Factors for Massive Transfusion Activation in Trauma Patients: A Systematic Review and Meta-analysis"],"prefix":"10.4103","volume":"17","author":[{"given":"Thosapol","family":"Ueamsaranworakul","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine, Thammasat University, Klong Luang, Pathum Thani, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratcharin","family":"Niamjumnong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine, Thammasat University, Klong Luang, Pathum Thani, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumpol","family":"Kornthatchapong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine, Thammasat University, Klong Luang, Pathum Thani, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winchana","family":"Srivilaithon","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Faculty of Medicine, Thammasat University, Klong Luang, Pathum Thani, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,8,28]]},"reference":[{"issue":"Suppl 1","key":"R4-20260427","doi-asserted-by":"crossref","first-page":"i71","DOI":"10.1093\/bja\/aet376","article-title":"Update on massive transfusion","volume":"111","author":"Pham","year":"2013","journal-title":"Br J Anaesth"},{"key":"R5-20260427","first-page":"434","article-title":"The effect of massive transfusion protocol implementation on the survival of trauma patients: A systematic review and meta-analysis","volume":"18","author":"Consunji","year":"2020","journal-title":"Blood Transfus"},{"key":"R6-20260427","first-page":"33","article-title":"Hemostatic resuscitation during surgery improves survival in patients with traumatic-induced coagulopathy","volume":"67","author":"Duchesne","year":"2009","journal-title":"J Trauma"},{"key":"R7-20260427","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R9-20260427","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"R10-20260427","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"R11-20260427","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1002\/jrsm.1411","article-title":"Risk-of-bias VISualization (robvis): An R package and Shiny web app for visualizing risk-of-bias assessments","volume":"12","author":"McGuinness","year":"2021","journal-title":"Res Synth Methods"},{"key":"R12-20260427","first-page":"S57","article-title":"A predictive model for massive transfusion in combat casualty patients","volume":"64","author":"McLaughlin","year":"2008","journal-title":"J Trauma"},{"issue":"Suppl 1","key":"R13-20260427","first-page":"S26","article-title":"Association of shock, coagulopathy, and initial vital signs with massive transfusion in combat casualties","volume":"69","author":"Larson","year":"2010","journal-title":"J Trauma"},{"key":"R14-20260427","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1186\/s13054-022-04178-8","article-title":"Early identification of bleeding in trauma patients: External validation of traumatic bleeding scores in the Swiss Trauma Registry","volume":"26","author":"Costa","year":"2022","journal-title":"Crit Care"},{"key":"R15-20260427","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s40560-014-0054-3","article-title":"Immediate screening method for predicting the necessity of massive transfusions in trauma patients: A retrospective single-center study","volume":"2","author":"Yumoto","year":"2014","journal-title":"J Intensive Care"},{"key":"R16-20260427","first-page":"1010","article-title":"Massive transfusion in trauma patients: Tissue hemoglobin oxygen saturation predicts poor outcome","volume":"64","author":"Moore","year":"2008","journal-title":"J Trauma"},{"key":"R17-20260427","doi-asserted-by":"crossref","first-page":"3560","DOI":"10.1007\/s00268-018-4674-y","article-title":"Massive transfusion: The Revised Assessment of Bleeding and Transfusion (RABT) score","volume":"42","author":"Joseph","year":"2018","journal-title":"World J Surg"},{"key":"R18-20260427","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.ajem.2016.02.072","article-title":"Modified traumatic bleeding severity score: Early determination of the need for massive transfusion","volume":"34","author":"Ogura","year":"2016","journal-title":"Am J Emerg Med"},{"key":"R19-20260427","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.ajem.2020.10.027","article-title":"Reverse shock index multiplied by Glasgow coma scale as a predictor of massive transfusion in trauma","volume":"46","author":"Lee","year":"2021","journal-title":"Am J Emerg Med"},{"key":"R20-20260427","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ajem.2019.01.056","article-title":"Pre-hospital modified shock index for prediction of massive transfusion and mortality in trauma patients","volume":"38","author":"Wang","year":"2020","journal-title":"Am J Emerg Med"},{"key":"R21-20260427","doi-asserted-by":"crossref","first-page":"199","DOI":"10.4103\/0974-2700.166597","article-title":"Effects of a hospital-wide introduction of a massive transfusion protocol on blood product ratio and blood product waste","volume":"8","author":"Balvers","year":"2015","journal-title":"J Emerg Trauma Shock"},{"key":"R22-20260427","doi-asserted-by":"crossref","first-page":"17","DOI":"10.4103\/jets.jets_86_21","article-title":"Outcomes of trauma patients present to the emergency department with a shock index of \u22651.0","volume":"15","author":"Chowdhury","year":"2022","journal-title":"J Emerg Trauma Shock"},{"key":"R23-20260427","doi-asserted-by":"crossref","first-page":"213","DOI":"10.4103\/JETS.JETS_45_19","article-title":"Characterization of acidosis in trauma patient","volume":"13","author":"Corwin","year":"2020","journal-title":"J Emerg Trauma Shock"},{"key":"R24-20260427","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4103\/0974-2700.76839","article-title":"Determinants of mortality in trauma patients following massive blood transfusion","volume":"4","author":"Rangarajan","year":"2011","journal-title":"J Emerg Trauma Shock"}],"container-title":["Journal of Emergencies, Trauma, and Shock"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jets.jets_19_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:53:31Z","timestamp":1786647211000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jets.jets_19_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,28]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/jets.jets_19_24","relation":{},"ISSN":["0974-2700","0974-519X"],"issn-type":[{"value":"0974-2700","type":"print"},{"value":"0974-519X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,28]]},"assertion":[{"value":"2024-01-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}